The failure of L-phenylalanine and UVA in the treatment of vitiligo

Al-Khawajah, Marwan M.

doi:10.3109/09546639609086883

Cited by 3 publications

(2 citation statements)

References 8 publications

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“…Some other studies, usually also lacking a comparator, were of mixed treatment modalities, e.g. including some sort of phototherapy, and are excluded from consideration here although they may be considered elsewhere 99–107 …”

Section: In All Patients With Vitiligo What Is the Efficacy Of Systementioning

confidence: 99%

“…including some sort of phototherapy, and are excluded from consideration here although they may be considered elsewhere. [99][100][101][102][103][104][105][106][107] A double-blind placebo-controlled trial looked at the effect of G. biloba extract for 6 months, in adults with spreading generalized and focal types of vitiligo, and also on repigmentation, in 47 subjects divided into two groups. 89 The authors showed that the G. biloba extract induced cessation of activity of the vitiligo in all subjects with acrofacial type (placebo induced cessation in one of six), in a third of those with symmetrical type called here 'vulgaris' (placebo one of six) and in a quarter with focal type (placebo seven of 10).…”

Section: Evidence Statementsmentioning

confidence: 99%

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Guideline for the diagnosis and management of vitiligo

Gawkrodger

Ormerod

Shaw

et al. 2008

British Journal of Dermatology

294

288

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Summary This detailed and user‐friendly guideline for the diagnosis and management of vitiligo in children and adults aims to give high quality clinical advice, based on the best available evidence and expert consensus, taking into account patient choice and clinical expertise. The guideline was devised by a structured process and is intended for use by dermatologists and as a resource for interested parties including patients. Recommendations and levels of evidence have been graded according to the method developed by the Scottish Inter‐Collegiate Guidelines Network. Where evidence was lacking, research recommendations were made. The types of vitiligo, process of diagnosis in primary and secondary care, and investigation of vitiligo were assessed. Treatments considered include offering no treatment other than camouflage cosmetics and sunscreens, the use of topical potent or highly potent corticosteroids, of vitamin D analogues, and of topical calcineurin inhibitors, and depigmentation with p‐(benzyloxy)phenol. The use of systemic treatment, e.g. corticosteroids, ciclosporin and other immunosuppressive agents was analyzed. Phototherapy was considered, including narrowband ultraviolet B (UVB), psoralen with ultraviolet A (UVA), and khellin with UVA or UVB, along with combinations of topical preparations and various forms of UV. Surgical treatments that were assessed include full‐thickness and split skin grafting, mini (punch) grafts, autologous epidermal cell suspensions, and autologous skin equivalents. The effectiveness of cognitive therapy and psychological treatments was considered. Therapeutic algorithms using grades of recommendation and levels of evidence have been produced for children and for adults with vitiligo.

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Section: In All Patients With Vitiligo What Is the Efficacy Of Systementioning

confidence: 99%

Section: Evidence Statementsmentioning

confidence: 99%

Guideline for the diagnosis and management of vitiligo

Gawkrodger

Ormerod

Shaw

et al. 2008

British Journal of Dermatology

294

288

View full text Add to dashboard Cite

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Nonsurgical Repigmentation Therapies in Vitiligo

Njoo¹,

Spuls²,

Bos³

et al. 1998

Arch Dermatol

223

208

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To assess the effectiveness and safety of nonsurgical repigmentation therapies in localized and generalized vitiligo by means of a meta-analysis.Data Sources: Computerized searches of bibliographic databases, a complementary manual literature search, and contacts with researchers and pharmaceutical firms.Study Selection: Predefined selection criteria were applied to both randomized and nonrandomized controlled trials.Data Extraction: Two investigators independently assessed the articles for inclusion. When there was a disagreement, a third investigator was consulted.Data Synthesis: Sixty-three studies were found on therapies for localized vitiligo. Of these, 10 of 11 randomized controlled trials and 29 of 110 patient series were included. One hundred seventeen studies on therapies for generalized vitiligo were found. Of these, 10 of 22 randomized controlled trials and 46 of 231 patient series were included. Among randomized controlled trials on localized vitiligo, the pooled odds ratio vs placebo was significant for topical class 3 corticosteroids (14.32; 95% confidence interval [CI], 2.45-83.72). In the patient series, topical class 3 and class 4 corticosteroids carried the highest mean success rates (56% [95% CI, 50%-62%] and 55% [95% CI, 49%-61%], respectively). Side effects were reported mostly with topical psoralen and intralesional and class 4 corticosteroids. In the randomized controlled trials on generalized vitiligo, the odds ratio vs placebo was significant for oral methoxsalen plus sunlight (23.37; 95% CI, 1.33-409.93), oral psoralen plus sunlight (19.87; 95% CI, 2.37-166.32), and oral trioxsalen plus sunlight (3.75; 95% CI,). In the series, the highest mean success rates were achieved with narrowband UV-B (63%; 95% CI, 50%-76%), broadband UV-B (57%; 95% CI, 29%-82%), and oral methoxsalen plus UV-A therapy (51%; 95% CI, 46%-56%). Oral methoxsalen plus UV-A was associated with the highest rates of side effects. No side effects were reported with UV-B therapy.Conclusions: Class 3 corticosteroids and UV-B therapy are the most effective and safest therapies for localized and for generalized vitiligo, respectively.

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Inflammatory Dermatoses

2011

British Association of Dermatologists' Management Guidelines

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The failure of L-phenylalanine and UVA in the treatment of vitiligo

Cited by 3 publications

References 8 publications

Guideline for the diagnosis and management of vitiligo

Guideline for the diagnosis and management of vitiligo

Nonsurgical Repigmentation Therapies in Vitiligo

Inflammatory Dermatoses

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